Abstract:
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Purpose: Near fatal asthma is well recognized as being a marker for increased risk of subsequent death from asthma. Analysis of airways on HRCT scanning can reflect well the airway abnormalities in living patients with asthma.
Methods and Materials: To search for the findings on HRCT specific for the fatality prone asthma, we semiquantitatively measured airway wall thickness, mucoid impaction, air trapping in 24 persistent asthmatics, 16 near fatal asthmatics and 16 normal control subjects. To evaluate the reversibility of these abnormalities, we followed up HRCT scanning after their symptoms and airflow limitation were relieved. The bronchial wall thickness, grade of mucoid impaction, and area of air trapping were higher in NFA and persistent asthmatics compared to those of normal controls.
Results: Mucoid impaction was observed only 46% in mild asthma and 70% in moderate to severe asthma, and 100% in near fatal asthma. Grade of mucoid impaction was significantly higher in near fatal asthma than either of patients with moderate to severe asthma and mild asthma. But bronchial wall thickness, and area of air trapping were not different between the three groups of asthma. In the 12 asthmatics who had undergone follow-up HRCT scan, air trapping, mucoid impaction and bronchial wall thickening were reversed, but partially, after asthma symptoms and airflow limitation were relieved.
Conclusion: We conclude that mucoid impaction is an useful finding on HRCT scan to predict near fatal asthma and the airway abnormalities are partially irreversible in asthma even after the treatment against airway inflammation.
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Paik MD, S,
Airway Morphology in Patients with Near-Fatal Asthma. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3108730.html
